The number of health insurers suing the Obama administration over the Affordable Care Act's hampered risk-corridor program continues to grow.
Blue Cross and Blue Shield of North Carolina filed a lawsuit Thursday, arguing it is owed $129 million in unpaid risk-corridor payments for the 2014 calendar year. The not-for-profit health plan also demanded the federal government pay legal costs and interest, according to a copy of the lawsuit.
Blue Cross and Blue Shield of North Carolina recorded more than $147 million in risk-corridor payments. However, the federal government has only been allowed to pay out 12.6% of insurers' requests. The insurer, which has experienced high medical costs from its ACA exchange population, expects it is owed another $175 million for the 2015 benefits year as well.
The North Carolina Blues' lawsuit comes just one day after Moda Health, an insurer based in Portland, Ore., filed its own risk-corridor lawsuit. Moda sued for $180 million that it says it is owed for 2014 and 2015. Moda has abandoned several exchanges, and Moda's ACA plans have engulfed the insurer in financial turmoil.
Both of those suits follow Highmark's move from last month. Highmark was the first major insurance company to sue the federal government over the risk-corridor program. A co-op in Oregon was the first insurer to pursue litigation over its risk-corridor payments.
According to Crain's Business Insurance, the CMS refused Highmark's request for full payment after the insurer tried to negotiate with the agency. Highmark also said the CMS has taken the position that “none of the risk corridor payments” for 2014, 2015 and 2016 are due until fall 2017 after the program has concluded.
The ACA created the three-year program to limit how much money health insurance companies could lose or gain in the early years of the exchanges. Plans with lower-than-expected medical claims pay into the program, and plans that had higher-than-expected costs receive money. However, the risk-corridors program has been caught in a political knife fight on Capitol Hill.
